The NHS is experiencing an “avalanche of need” regarding autism and attention deficit hyperactivity disorder (ADHD), but the system set up to cope with rising demand for assessments and treatments is “outdated”, a health think tank has warned.
There needs to be a “radical rethink” of the way people with the conditions are cared for in England if the health service is to meet the rapidly growing need for services, the Nuffield Trust has said.
The think tank is calling for a ‘whole systems approach’ across education, society and the NHS, amid changing social attitudes and greater awareness of circumstances. It comes days after the NHS announced a major overhaul of ADHD services.
Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredictable and unprecedented rise in demand for autism assessments and ADHD treatments has completely overtaken the NHS’s ability to meet it. It’s honestly impossible to imagine how the system can grow fast enough to meet this demand.
“We should not underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families are suffering while they wait.”
Figures published by NHS Digital last month showed that the number of patients waiting for an autism assessment in England was at the highest level since current data started in April 2019.
In December 2023, about 172,040 people were on waiting lists, up from 117,020 a year earlier and more than five times the 32,220 in December 2019.
Although the National Institute for Health and Care Excellence (Nice) recommends that people suspected of autism should be diagnosed within three months of referral, statistics show that 147,070 patients waited at least 13 weeks in December, more than six times the 24,250 in December. December 2019.
A new analysis of the data by the Nuffield Trust found that 79% of people who had waited 13 weeks or more had not had a first appointment with a specialist, up from 44% in December 2019.
Between October and December last year, those who had their first appointment had waited an average of nine months since referral. In December 2019, the average waiting time was four months, the think tank says.
The Nuffield Trust also warned that ADHD waiting times could go unnoticed due to a lack of nationally published data. It said there was a 51% increase in the number of people prescribed medication for ADHD.
The analysis showed a 28% increase in the number of drugs prescribed to 10- to 14-year-olds, and a 146% increase among 30- to 34-year-olds.
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“We’re just beginning to realize how many people are neurodiverse,” Stein said. “The challenge is that we have an outdated healthcare model to meet this avalanche of needs. The dramatic increase described in our analysis is likely due to a combination of changing social attitudes and increased awareness.
“We urgently need to understand the different elements of this complex picture and find a system-wide approach across education, society as a whole and healthcare. Pumping more money into the current model is certainly not the solution: a radical rethink is needed.”
An NHS spokesperson said: “The NHS is fully committed to supporting and improving the lives of people with ADHD and autism. That’s why we’ve published new national guidance to help local areas manage the 50% increase in referrals they’ve seen in recent times. year.
“NHS England has also begun important work investigating challenges in ADHD services and last month launched a cross-sector taskforce with the government to help provide a joined-up approach for the growing number of people who comes forward for support.”
